Provider Demographics
NPI:1942790746
Name:WHITTENHALL, ELAINA D (ATR-BC, LPC-AT, LCPC)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:D
Last Name:WHITTENHALL
Suffix:
Gender:F
Credentials:ATR-BC, LPC-AT, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 BEE CAVES RD STE A204
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6429
Mailing Address - Country:US
Mailing Address - Phone:512-675-1873
Mailing Address - Fax:512-287-5531
Practice Address - Street 1:3939 BEE CAVES RD STE A204
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6429
Practice Address - Country:US
Practice Address - Phone:512-675-1873
Practice Address - Fax:512-287-5531
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17-423221700000X
TX79511101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist